Paul E Hazelrig Jr., M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A24229 Issued in CA

Practice address

77 N San Mateo Dr
Suite 1
San Mateo, CA 94401-2889

Phone

(650) 342-0854

Fax

(650) 342-2198

NPI assigned

Jul 30, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: peh103pcs@m1125.primeclinicalsystems.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• San Mateo Orthopedic Medical Group Inc

  • Specialist
  • San Mateo, CA
  • NPI 1679624563
  Medicare reassignment NPD Authorized official
• Palo Alto Medical Foundation

  • Non-Pharmacy Dispensing Site
  • Santa Cruz, CA
  • NPI 1114182649
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1477568061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 N SAN MATEO DR",
            "address_2": "SUITE 1",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012889",
            "telephone_number": "650-342-0854",
            "fax_number": "650-342-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N SAN MATEO DR",
            "address_2": "SUITE 1",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012889",
            "telephone_number": "650-342-0854",
            "fax_number": "650-342-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELRIG",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A24229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Jane Hawkins, ACSW
• David M Hayashi, D.D.S.
• Rosanne Hayes
• Lynne Haynes-Tucker, MD
• Allen Haysbert, C.A.T.C.
• Kelsea Hazlehurst
• Mark Cameron Head
• Marcia Dolores Headley
• Heal Physical Therapy Inc
• Heal Psychiatric Services, Inc

• Specialist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.